In this paper pitfalls in risk assessment for high molecular weight allergens, which can cause typical Type I/IgE-mediated respiratory allergy, are discussed. The major pitfalls seem to be that no agreement exists on the preferential end point that should be used in risk assessment. As a result, it is unclear which exposure-response relationship should be considered. In addition, there is a lack of data on health risks for non-occupationally exposed reference populations, so the baseline risk is often not known and little is known about the shape of exposure-response relationships and the existence of exposure thresholds. The good news is that more and more groups have published exposure-response relationships for several allergens. The possibilities for risk assessment approaches that should lead to occupational exposure standards are explored. Specific consideration is given to situations in which data on exposure-response relationships for humans are available. Considerable progress has been made in this area by use of advanced statistical techniques for exposure-response modelling. The major practical constraint at this moment seems to be the absence of well-standardized measurement techniques (immunoassays) for the evaluation of allergen exposure in the field.
{"title":"Health-based occupational exposure limits for high molecular weight sensitizers: how long is the road we must travel?","authors":"D. Heederik, P. Thorne, G. Doekes","doi":"10.1093/ANNHYG/MEF062","DOIUrl":"https://doi.org/10.1093/ANNHYG/MEF062","url":null,"abstract":"In this paper pitfalls in risk assessment for high molecular weight allergens, which can cause typical Type I/IgE-mediated respiratory allergy, are discussed. The major pitfalls seem to be that no agreement exists on the preferential end point that should be used in risk assessment. As a result, it is unclear which exposure-response relationship should be considered. In addition, there is a lack of data on health risks for non-occupationally exposed reference populations, so the baseline risk is often not known and little is known about the shape of exposure-response relationships and the existence of exposure thresholds. The good news is that more and more groups have published exposure-response relationships for several allergens. The possibilities for risk assessment approaches that should lead to occupational exposure standards are explored. Specific consideration is given to situations in which data on exposure-response relationships for humans are available. Considerable progress has been made in this area by use of advanced statistical techniques for exposure-response modelling. The major practical constraint at this moment seems to be the absence of well-standardized measurement techniques (immunoassays) for the evaluation of allergen exposure in the field.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116919501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVES Most studies to date on sound levels in entertainment establishments have concentrated on exposure levels for the attending public, rather than employees who may be at greater risk of hearing loss. Of particular concern are young employees. The aim of this pilot study was to (i) estimate typical sound levels in different areas where amplified music was played, (ii) measure temporary threshold shift (TTS) and (iii) estimate the dependence of hearing threshold shifts on measured noise levels. METHODS This study focused on students working part-time (up to 16 h/week) in music bars and discotheques in a university entertainment venue. All 28 staff were invited to participate in the study. Pre- and post-exposure audiometry was used to determine hearing threshold at both high and low frequencies. Personal dosemeters and static measurements were made to assess noise levels and frequency characteristics. A questionnaire was used to determine patterns of noise exposure and attitudes to noise levels and hearing loss. RESULTS Of the 28 student employees working in the three areas, 14 (50%) agreed to take part in the study, giving 21 pre- and post-shift audiograms. The mean personal exposure levels for security staff were higher than those of bar staff, with both groups exceeding 90 dB(A). The maximum peak pressure reading for security staff was 124 dB. Although TTS values were moderate, they were found to be highly significant at both low and high frequencies and for both ears. Twenty-nine per cent of subjects showed permanent hearing loss of more than 30 dB at either low or high frequencies. The correlation between TTS and personal exposure was higher at 4 kHz than the low and high frequencies. CONCLUSIONS Contemporary music may be an important yet little considered contributor to total personal noise exposure, especially amongst young employees. Employees need to be better informed of risks of hearing loss and the need to report changes in hearing acuity. Suggestions are made on strategies for improving the assessment of noise exposure in entertainment venues.
{"title":"Noise exposure and hearing loss among student employees working in university entertainment venues.","authors":"S. Sadhra, C. Jackson, T. Ryder, M. J. Brown","doi":"10.1093/ANNHYG/46.5.455","DOIUrl":"https://doi.org/10.1093/ANNHYG/46.5.455","url":null,"abstract":"OBJECTIVES\u0000Most studies to date on sound levels in entertainment establishments have concentrated on exposure levels for the attending public, rather than employees who may be at greater risk of hearing loss. Of particular concern are young employees. The aim of this pilot study was to (i) estimate typical sound levels in different areas where amplified music was played, (ii) measure temporary threshold shift (TTS) and (iii) estimate the dependence of hearing threshold shifts on measured noise levels.\u0000\u0000\u0000METHODS\u0000This study focused on students working part-time (up to 16 h/week) in music bars and discotheques in a university entertainment venue. All 28 staff were invited to participate in the study. Pre- and post-exposure audiometry was used to determine hearing threshold at both high and low frequencies. Personal dosemeters and static measurements were made to assess noise levels and frequency characteristics. A questionnaire was used to determine patterns of noise exposure and attitudes to noise levels and hearing loss.\u0000\u0000\u0000RESULTS\u0000Of the 28 student employees working in the three areas, 14 (50%) agreed to take part in the study, giving 21 pre- and post-shift audiograms. The mean personal exposure levels for security staff were higher than those of bar staff, with both groups exceeding 90 dB(A). The maximum peak pressure reading for security staff was 124 dB. Although TTS values were moderate, they were found to be highly significant at both low and high frequencies and for both ears. Twenty-nine per cent of subjects showed permanent hearing loss of more than 30 dB at either low or high frequencies. The correlation between TTS and personal exposure was higher at 4 kHz than the low and high frequencies.\u0000\u0000\u0000CONCLUSIONS\u0000Contemporary music may be an important yet little considered contributor to total personal noise exposure, especially amongst young employees. Employees need to be better informed of risks of hearing loss and the need to report changes in hearing acuity. Suggestions are made on strategies for improving the assessment of noise exposure in entertainment venues.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117050887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Solvent mixture concentrations in paint and resin manufacture were on-line monitored using a portable open path Fourier transform infrared (OP-FTIR) analyser in order to determine solvent emission rates into workspaces. The mean solvent emission rate was 0.46 kg/h in paint production and 0.35 kg/h in resin manufacture. Expressed as emission factor, i.e. evaporated portion of the total solvent mass used, the corresponding values were 0.01% for paint production and 0.1% for resin manufacture. The OP-FTIR instrument together with advanced spectra analysis software facilitated a rapid identification of solvent mixtures and on-line concentration monitoring with good temporal resolution. The analyser seems to be particularly useful in industrial hygiene applications where spatial average concentrations are needed. The further benefit of the open path instrument is that no sampling lines, pumps or sample cells are needed.
{"title":"On-line monitoring of solvent emission rates using an open path FTIR analyser.","authors":"J. Räisänen, R. Niemelä","doi":"10.1093/ANNHYG/46.5.501","DOIUrl":"https://doi.org/10.1093/ANNHYG/46.5.501","url":null,"abstract":"Solvent mixture concentrations in paint and resin manufacture were on-line monitored using a portable open path Fourier transform infrared (OP-FTIR) analyser in order to determine solvent emission rates into workspaces. The mean solvent emission rate was 0.46 kg/h in paint production and 0.35 kg/h in resin manufacture. Expressed as emission factor, i.e. evaporated portion of the total solvent mass used, the corresponding values were 0.01% for paint production and 0.1% for resin manufacture. The OP-FTIR instrument together with advanced spectra analysis software facilitated a rapid identification of solvent mixtures and on-line concentration monitoring with good temporal resolution. The analyser seems to be particularly useful in industrial hygiene applications where spatial average concentrations are needed. The further benefit of the open path instrument is that no sampling lines, pumps or sample cells are needed.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132998450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Egeghy, L. Nylander-French, K. Gwin, I. Hertz-Picciotto, S. Rappaport
Automobile mechanics are exposed to benzene through their contact with gasoline vapor and engine exhaust. This study investigated the benzene uptake associated with these exposures. We first evaluated the reliability of self-collected breath samples among a subset of subjects and found good agreement between these samples and those collected under expert supervision (intraclass correlation coefficient 0.79, n = 69). We then used self-monitoring together with a longitudinal sampling design (with up to three measurements per worker) to measure benzene in air and benzene in end-exhaled breath among 81 workers from 12 automobile repair garages in North Carolina. A statistically significant difference (P < 0.0001, Mann-Whitney rank sum test) was observed between non-smokers and smokers for post-exposure benzene concentration in breath (median values of 18.9 and 39.1 micro g/m(3), respectively). Comparing pre- and post-exposure breath concentrations within these two groups, the difference was significant among non-smokers (P < 0.0001) but not significant among smokers (P > 0.05). Mixed effects regression analysis using backwards elimination yielded five significant predictors of benzene concentration in breath, namely benzene exposure (P < 0.0001), pre-exposure benzene concentration in breath (P = 0.021), smoking status (P < 0.0001), fuel system work (P = 0.0043) and carburetor cleaner use (P < 0.0001). The between-person variance component comprised only 28% of the total variance in benzene levels in breath, indicating that differences among individuals related to physiological and metabolic characteristics had little influence on benzene uptake among these workers.
{"title":"Self-collected breath sampling for monitoring low-level benzene exposures among automobile mechanics.","authors":"P. Egeghy, L. Nylander-French, K. Gwin, I. Hertz-Picciotto, S. Rappaport","doi":"10.1093/ANNHYG/MEF057","DOIUrl":"https://doi.org/10.1093/ANNHYG/MEF057","url":null,"abstract":"Automobile mechanics are exposed to benzene through their contact with gasoline vapor and engine exhaust. This study investigated the benzene uptake associated with these exposures. We first evaluated the reliability of self-collected breath samples among a subset of subjects and found good agreement between these samples and those collected under expert supervision (intraclass correlation coefficient 0.79, n = 69). We then used self-monitoring together with a longitudinal sampling design (with up to three measurements per worker) to measure benzene in air and benzene in end-exhaled breath among 81 workers from 12 automobile repair garages in North Carolina. A statistically significant difference (P < 0.0001, Mann-Whitney rank sum test) was observed between non-smokers and smokers for post-exposure benzene concentration in breath (median values of 18.9 and 39.1 micro g/m(3), respectively). Comparing pre- and post-exposure breath concentrations within these two groups, the difference was significant among non-smokers (P < 0.0001) but not significant among smokers (P > 0.05). Mixed effects regression analysis using backwards elimination yielded five significant predictors of benzene concentration in breath, namely benzene exposure (P < 0.0001), pre-exposure benzene concentration in breath (P = 0.021), smoking status (P < 0.0001), fuel system work (P = 0.0043) and carburetor cleaner use (P < 0.0001). The between-person variance component comprised only 28% of the total variance in benzene levels in breath, indicating that differences among individuals related to physiological and metabolic characteristics had little influence on benzene uptake among these workers.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121796298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Tielemans, Y. Christopher, H. Marquart, M. Groenewold, J. V. van Hemmen
In a recent issue of this journal, Money and Margary (2002) proposed some thoughtful guidelines for exposure assessment in regulatory risk assessment. Their structured approach acknowledges that currently available exposure data are of very variable quality (Northage and Marquart, 2001). We firmly underline their plea for a hierarchy in available exposure information sources, with a higher weight assigned to data with a lower level of uncertainty. The level of confidence an assessor has in the available exposure information should play an important role in the resultant risk assessment process. Moreover, the classification of data into different uncertainty categories should aid the assessor when conflicting exposure results are reported. Hence, a transparent system quantifying heterogeneity in data quality is crucial if one wants to arrive at consistent risk assessments. The approach of Money and Margary largely coincides with and was to some extent complementary to our decision tree for data quality evaluation published in the same issue (Tielemans et al., 2002). However, we question their statement that all exposure information sources should be considered as being potentially useful in the risk assessment process. On the contrary, it is our opinion that not all exposure information meets even the minimum requirements for incorporation in the exposure assessment process and the exclusion of such data should be the starting point for a transparent and robust exposure assessment. In our paper we defined minimum requirements for four different aspects, i.e. available occupational hygiene information, variability and precision issues, internal validity and external validity. We consider data sources to be unacceptable if very basic requirements are not fulfilled for these aspects. In these cases, the level of uncertainty or bias related to exposure data is in our view difficult to interpret in even a broad sense. In order to evaluate the quality of data in current European Union risk assessments of existing substances, we conducted a small-scale inventory of exposure data. One exposure assessor of our department evaluated data quality of 40 measurement series selected out of five Risk Assessment Reports (RARs). A second researcher also evaluated 20 of these sources in order to study agreement between assessors. The data classification was done according to both a strict and a lenient interpretation of our decision tree (Tielemans et al., 2002). The former implies a rigid adherence of the assessor to the rules of the decision tree. Any non-compliance to the decision rules results in exclusion of the data. The latter refers to an approach that leaves more room for subjective assessment tailored to the specific exposure assessment situation. Table 1 describes the results of our inventory. It is a striking finding that 80% of the information sources were excluded when a strict classification was applied. A lenient approach also yielded exclusion of se
在最近一期的本刊中，Money和Margary(2002)为监管风险评估中的暴露评估提出了一些深思熟虑的指导方针。他们的结构化方法承认，目前可用的暴露数据质量变化很大(Northage和Marquart, 2001)。我们坚定地强调他们对可用暴露信息源的层次结构的请求，对不确定性较低的数据赋予较高的权重。评估人员对现有暴露信息的信任程度应在由此产生的风险评估过程中发挥重要作用。此外，将数据分类为不同的不确定性类别应该有助于评估者在报告冲突的暴露结果时。因此，如果想要达到一致的风险评估，一个透明的系统量化数据质量的异质性是至关重要的。Money和Margary的方法在很大程度上与我们发表在同一期杂志上的数据质量评估决策树相一致，并在某种程度上是互补的(Tielemans et al.， 2002)。然而，我们质疑他们关于在风险评估过程中所有暴露信息源都应被视为潜在有用的说法。相反，我们认为并非所有暴露信息都符合纳入暴露评估过程的最低要求，排除此类数据应成为透明和可靠的暴露评估的起点。在本文中，我们定义了四个不同方面的最低要求，即可用的职业卫生信息，变异性和准确性问题，内部效度和外部效度。如果不能满足这些方面的基本要求，我们认为数据源是不可接受的。在这些情况下，我们认为，与暴露数据有关的不确定性或偏差程度即使从广义上也难以解释。为了评估当前欧盟现有物质风险评估数据的质量，我们对暴露数据进行了小规模清查。我科一名暴露评估员对5份风险评估报告(RARs)中选取的40个测量系列的数据质量进行了评估。另一名研究人员也评估了其中的20个来源，以研究评估者之间的一致性。数据分类是根据我们的决策树的严格和宽松的解释来完成的(Tielemans等人，2002年)。前者意味着评估者严格遵守决策树的规则。任何不遵守决策规则的情况都会导致数据被排除在外。后者是指根据具体的暴露评估情况，为主观评估留出更多空间的方法。表1描述了我们盘点的结果。这是一个惊人的发现，80%的信息来源被排除在严格的分类应用。一种宽松的方法也产生了几个测量系列的排除(12.5%)，尽管大多数评级转向补充信息(80%)。应当指出，在这两种方法中，只有一小部分来源提供了充分的资料。对于严格和宽松的方法，两个评估者之间的同意百分比分别为85%和70%。这种差异与预期是一致的，因为不那么严格的方法在很大程度上依赖于主观判断。我们的分析结果清楚地说明了严格的评估和宽松的方法之间的对比，前者认为大多数数据是无用的，而后者允许将大多数数据纳入风险评估过程。从这份清单中可以了解到，大部分调查数据受到职业卫生信息记录不良、精度低或有效性可疑的阻碍。科学上严格的评估将把这些数据归为无关紧要。我们同意Money和Margary的观点，因为
{"title":"Excluding exposure data of very poor quality is a core principle for regulatory risk assessment.","authors":"E. Tielemans, Y. Christopher, H. Marquart, M. Groenewold, J. V. van Hemmen","doi":"10.1093/ANNHYG/MEF073","DOIUrl":"https://doi.org/10.1093/ANNHYG/MEF073","url":null,"abstract":"In a recent issue of this journal, Money and Margary (2002) proposed some thoughtful guidelines for exposure assessment in regulatory risk assessment. Their structured approach acknowledges that currently available exposure data are of very variable quality (Northage and Marquart, 2001). We firmly underline their plea for a hierarchy in available exposure information sources, with a higher weight assigned to data with a lower level of uncertainty. The level of confidence an assessor has in the available exposure information should play an important role in the resultant risk assessment process. Moreover, the classification of data into different uncertainty categories should aid the assessor when conflicting exposure results are reported. Hence, a transparent system quantifying heterogeneity in data quality is crucial if one wants to arrive at consistent risk assessments. The approach of Money and Margary largely coincides with and was to some extent complementary to our decision tree for data quality evaluation published in the same issue (Tielemans et al., 2002). However, we question their statement that all exposure information sources should be considered as being potentially useful in the risk assessment process. On the contrary, it is our opinion that not all exposure information meets even the minimum requirements for incorporation in the exposure assessment process and the exclusion of such data should be the starting point for a transparent and robust exposure assessment. In our paper we defined minimum requirements for four different aspects, i.e. available occupational hygiene information, variability and precision issues, internal validity and external validity. We consider data sources to be unacceptable if very basic requirements are not fulfilled for these aspects. In these cases, the level of uncertainty or bias related to exposure data is in our view difficult to interpret in even a broad sense. In order to evaluate the quality of data in current European Union risk assessments of existing substances, we conducted a small-scale inventory of exposure data. One exposure assessor of our department evaluated data quality of 40 measurement series selected out of five Risk Assessment Reports (RARs). A second researcher also evaluated 20 of these sources in order to study agreement between assessors. The data classification was done according to both a strict and a lenient interpretation of our decision tree (Tielemans et al., 2002). The former implies a rigid adherence of the assessor to the rules of the decision tree. Any non-compliance to the decision rules results in exclusion of the data. The latter refers to an approach that leaves more room for subjective assessment tailored to the specific exposure assessment situation. Table 1 describes the results of our inventory. It is a striking finding that 80% of the information sources were excluded when a strict classification was applied. A lenient approach also yielded exclusion of se","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116879532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exposure to cytotoxic drugs is of great concern today. Special regulations for handling these drugs during preparation and administration have been implemented in most countries. Concern has also been raised as to whether exposure to these drugs can occur due to contaminated drug vials. In this investigation, wipe samples were taken from drug vials used for platinum-containing drugs, e.g. cisplatin and related drugs. The vials were randomly picked from unbroken packages from different manufacturers. The results showed that drug vials may already be contaminated on the outside when delivered from the manufacturer.
{"title":"Cisplatin contamination observed on the outside of drug vials.","authors":"O. Nygren, B. Gustavsson, L. Ström, A. Friberg","doi":"10.1093/ANNHYG/MEF074","DOIUrl":"https://doi.org/10.1093/ANNHYG/MEF074","url":null,"abstract":"Exposure to cytotoxic drugs is of great concern today. Special regulations for handling these drugs during preparation and administration have been implemented in most countries. Concern has also been raised as to whether exposure to these drugs can occur due to contaminated drug vials. In this investigation, wipe samples were taken from drug vials used for platinum-containing drugs, e.g. cisplatin and related drugs. The vials were randomly picked from unbroken packages from different manufacturers. The results showed that drug vials may already be contaminated on the outside when delivered from the manufacturer.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126239782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since the Control of Substances Hazardous to Health (COSHH) Regulations came into force about 12 yr ago, Britain has had a legally enforceable system of exposure limits. This is now likely to have a major overhaul. There are at present two types of limit, Occupational Exposure Standards (OESs), which broadly speaking are supposed to be set low enough to prevent any ill-health developing, and Maximum Exposure Limits (MELs), which are set for substances that have ‘serious health implications’ and for which it is not always practicable to achieve a level that will prevent disease. OESs can be exceeded under some circumstances, and exposure by inhalation does not have to be reduced any further than the OES. MELs define a maximum permissible exposure, but exposure must also be reduced as far as reasonably practicable. (This is a legally defined concept which means that exposures must be reduced to a level where further reduction would involve a cost grossly disproportionate to the benefit achieved.) Topping (2001) recently described the system in detail. The list of limits, and guidance aimed at employers, is published annually in EH40 (Health and Safety Executive, 2002). This system has strengths, notably the frank recognition that for some substances a desirable limit to protect health is not practicable, and the involvement of experts nominated by employers’ and employees’ organizations and other interests in determining for which substances a MEL is applicable, and what the level should be. However, a market survey on behalf of the Health and Safety Executive (HSE) showed that the carefully negotiated and executed dual-limit system was an almost complete failure in terms of the all-important understanding and application by users of chemicals (Topping et al., 1998). There were other problems intrinsic to the system which have become more troublesome as time has gone by, and the need to run a system compatible with the European Union’s Chemical Agents Directive has increased the problems. The HSE has now issued a discussion document on a possible new scheme with a view eventually to changing the COSHH Regulations. The document can be downloaded from http://www.hse.gov.uk/condocs, and comments are invited by the end of July; but there will be a further consultation later on the more formal legislative proposals.
{"title":"Occupational exposure limits--Britain tries again.","authors":"T. Ogden","doi":"10.1093/ANNHYG/46.5.435","DOIUrl":"https://doi.org/10.1093/ANNHYG/46.5.435","url":null,"abstract":"Since the Control of Substances Hazardous to Health (COSHH) Regulations came into force about 12 yr ago, Britain has had a legally enforceable system of exposure limits. This is now likely to have a major overhaul. There are at present two types of limit, Occupational Exposure Standards (OESs), which broadly speaking are supposed to be set low enough to prevent any ill-health developing, and Maximum Exposure Limits (MELs), which are set for substances that have ‘serious health implications’ and for which it is not always practicable to achieve a level that will prevent disease. OESs can be exceeded under some circumstances, and exposure by inhalation does not have to be reduced any further than the OES. MELs define a maximum permissible exposure, but exposure must also be reduced as far as reasonably practicable. (This is a legally defined concept which means that exposures must be reduced to a level where further reduction would involve a cost grossly disproportionate to the benefit achieved.) Topping (2001) recently described the system in detail. The list of limits, and guidance aimed at employers, is published annually in EH40 (Health and Safety Executive, 2002). This system has strengths, notably the frank recognition that for some substances a desirable limit to protect health is not practicable, and the involvement of experts nominated by employers’ and employees’ organizations and other interests in determining for which substances a MEL is applicable, and what the level should be. However, a market survey on behalf of the Health and Safety Executive (HSE) showed that the carefully negotiated and executed dual-limit system was an almost complete failure in terms of the all-important understanding and application by users of chemicals (Topping et al., 1998). There were other problems intrinsic to the system which have become more troublesome as time has gone by, and the need to run a system compatible with the European Union’s Chemical Agents Directive has increased the problems. The HSE has now issued a discussion document on a possible new scheme with a view eventually to changing the COSHH Regulations. The document can be downloaded from http://www.hse.gov.uk/condocs, and comments are invited by the end of July; but there will be a further consultation later on the more formal legislative proposals.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121584249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Exposure to chrysotile dust has been associated with the development of mesothelioma and recent studies have implicated contaminating tremolite fibers as the likely etiological factor. Tremolite also contaminates talc, the most common non-asbestos mineral fiber in our control cases. METHODS We examined 312 cases of mesothelioma for which fiber burden analyses of lung parenchyma had been performed by means of scanning electron microscopy to determine the content of tremolite, non-commercial amphiboles, talc and chrysotile. The vast majority of these patients were exposed to dust from products containing asbestos. RESULTS Tremolite was identified in 166 of 312 cases (53%) and was increased above background levels in 81 cases (26%). Fibrous talc was identified in 193 cases (62%) and correlated strongly with the tremolite content (P < 0.0001). Chrysotile was identified in only 32 cases (10%), but still correlated strongly with the tremolite content (P < 0.0001). Talc levels explained less of the tremolite deviance for cases with an increased tremolite level than for cases with a normal range tremolite level (22 versus 42%). In 14 cases (4.5%) non-commercial amphibole fibers (tremolite, actinolite and/or anthophyllite) were the only fiber types found above background. CONCLUSIONS We conclude that tremolite in lung tissue samples from mesothelioma victims derives from both talc and chrysotile and that tremolite accounts for a considerable fraction of the excess fiber burden in end-users of asbestos products.
{"title":"Tremolite and mesothelioma.","authors":"V. Roggli, R. Vollmer, K. Butnor, T. Sporn","doi":"10.1093/ANNHYG/46.5.447","DOIUrl":"https://doi.org/10.1093/ANNHYG/46.5.447","url":null,"abstract":"BACKGROUND\u0000Exposure to chrysotile dust has been associated with the development of mesothelioma and recent studies have implicated contaminating tremolite fibers as the likely etiological factor. Tremolite also contaminates talc, the most common non-asbestos mineral fiber in our control cases.\u0000\u0000\u0000METHODS\u0000We examined 312 cases of mesothelioma for which fiber burden analyses of lung parenchyma had been performed by means of scanning electron microscopy to determine the content of tremolite, non-commercial amphiboles, talc and chrysotile. The vast majority of these patients were exposed to dust from products containing asbestos.\u0000\u0000\u0000RESULTS\u0000Tremolite was identified in 166 of 312 cases (53%) and was increased above background levels in 81 cases (26%). Fibrous talc was identified in 193 cases (62%) and correlated strongly with the tremolite content (P < 0.0001). Chrysotile was identified in only 32 cases (10%), but still correlated strongly with the tremolite content (P < 0.0001). Talc levels explained less of the tremolite deviance for cases with an increased tremolite level than for cases with a normal range tremolite level (22 versus 42%). In 14 cases (4.5%) non-commercial amphibole fibers (tremolite, actinolite and/or anthophyllite) were the only fiber types found above background.\u0000\u0000\u0000CONCLUSIONS\u0000We conclude that tremolite in lung tissue samples from mesothelioma victims derives from both talc and chrysotile and that tremolite accounts for a considerable fraction of the excess fiber burden in end-users of asbestos products.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126068783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this paper is to present a paradigm for combining ordinal expert ratings with exposure measurements while accounting for a between-worker effect when estimating exposure group (EG)-specific means for epidemiological purposes. Expert judgement is used to classify the EGs into a limited number of exposure levels independently of the exposure measurements. The mean exposure of each EG is considered to be a random deviate from a central exposure rating-specific value. Combining this approach with the standard between-worker random effect model, we obtain a nested two-way model. Using Gibbs sampling, we can fit such models incorporating prior information on components of variance and modelling options to the rating-specific means. An approximate formula is presented estimating the mean exposure of each EG as a function of the geometric mean of the measurements in this EG, between and within EG standard deviations and the overall geometric mean, thus borrowing information from other EGs. We apply this paradigm to an actual data set of dust exposure measurements in a steel producing factory. Some EG-specific means are quite different from the estimates including the ratings. Rating-specific means could be estimated under different hypotheses. It is argued that when setting up an expert rating of exposures it is best done independently of existing exposure measurements. The present model is then a convenient framework in which to combine the two sources of information.
{"title":"Combining expert ratings and exposure measurements: a random effect paradigm.","authors":"P. Wild, E. Sauleau, E. Bourgkard, J. Moulin","doi":"10.1093/ANNHYG/MEF052","DOIUrl":"https://doi.org/10.1093/ANNHYG/MEF052","url":null,"abstract":"The aim of this paper is to present a paradigm for combining ordinal expert ratings with exposure measurements while accounting for a between-worker effect when estimating exposure group (EG)-specific means for epidemiological purposes. Expert judgement is used to classify the EGs into a limited number of exposure levels independently of the exposure measurements. The mean exposure of each EG is considered to be a random deviate from a central exposure rating-specific value. Combining this approach with the standard between-worker random effect model, we obtain a nested two-way model. Using Gibbs sampling, we can fit such models incorporating prior information on components of variance and modelling options to the rating-specific means. An approximate formula is presented estimating the mean exposure of each EG as a function of the geometric mean of the measurements in this EG, between and within EG standard deviations and the overall geometric mean, thus borrowing information from other EGs. We apply this paradigm to an actual data set of dust exposure measurements in a steel producing factory. Some EG-specific means are quite different from the estimates including the ratings. Rating-specific means could be estimated under different hypotheses. It is argued that when setting up an expert rating of exposures it is best done independently of existing exposure measurements. The present model is then a convenient framework in which to combine the two sources of information.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124241998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. McCanlies, D. Landsittel, B. Yucesoy, V. Vallyathan, Michael Luster, D. Sharp
Over the last decade the role of genetic data in epidemiological research has expanded considerably. We recently published a case-control study that evaluated the interaction between silica exposure and minor variants in the genes coding for interleukin-1alpha (IL-1alpha), interleukin-1 receptor antagonist (IL-1RA) and tumor necrosis factor alpha (TNFalpha) as risk factors associated with silicosis, a fibrotic lung disease. In contrast, this report uses data generated from these studies to illustrate the utility of genetic information for the purposes of risk assessment and clinical prediction. Specifically, this study will address how, given a known exposure, genetic information affects the characterization of risk groups. Relative operating characteristic (ROC) curves were then used to determine the impact of genetic information on individual classification. Logistic regression modeling procedures were used to estimate the predicted probability of developing silicosis. This probability was then used to construct predicted risk deciles, first for a model with occupational exposure only and then for a model containing occupational exposure and genetic main effects and interactions. Results indicate that the exposure-only model effectively captures an increasing relationship between predicted risk deciles and prevalence of observed silicosis cases. Individuals comprising the highest risk decile were almost four times as likely to have silicosis as opposed to the lowest risk decile. The addition of genetic data, however, substantially improved characterization of risk categories; the proportion of cases in the highest risk decile was almost eight times that in the lowest risk decile. However, the ROC curve and classification analysis demonstrated that the addition of genetic main effects and interactions did not significantly impact on prediction of the individual's case status. These results indicate that genetic information plays a valuable role in effectively characterizing risk groups and mechanisms of disease operating in a substantial proportion of the population. However, in the case of fibrotic lung disease caused by silica exposure, information about the presence or absence of the minor variants of IL-1alpha, IL-1RA and TNFalpha is unlikely to be a useful tool for individual classification.
在过去十年中，遗传数据在流行病学研究中的作用已大大扩大。我们最近发表了一项病例对照研究，评估了二氧化硅暴露与白细胞介素-1 α (il -1 α)、白细胞介素-1受体拮拮剂(IL-1RA)和肿瘤坏死因子α (TNFalpha)编码基因的微小变异之间的相互作用，这些基因是与矽肺(一种纤维化肺部疾病)相关的危险因素。相比之下，本报告使用这些研究产生的数据来说明遗传信息在风险评估和临床预测方面的效用。具体来说，本研究将探讨在已知暴露的情况下，遗传信息如何影响风险群体的特征。然后使用相对工作特征(ROC)曲线来确定遗传信息对个体分类的影响。采用Logistic回归模型程序估计矽肺病的预测概率。然后，这个概率被用来构建预测的风险十分位数，首先是一个只有职业暴露的模型，然后是一个包含职业暴露和遗传主要影响和相互作用的模型。结果表明，仅暴露模型有效地捕获了预测风险十分位数与观察到的矽肺病例患病率之间日益增加的关系。最高风险十分位数的个体患矽肺病的可能性几乎是最低风险十分位数的四倍。然而，遗传数据的增加大大改善了危险类别的特征;最高风险十分位数的病例比例几乎是最低风险十分位数的八倍。然而，ROC曲线和分类分析表明，遗传主效应和相互作用的加入对个体病例状态的预测没有显著影响。这些结果表明，遗传信息在有效表征风险群体和在相当大比例人口中运作的疾病机制方面起着宝贵的作用。然而，在由二氧化硅暴露引起的纤维化肺病的情况下，关于IL-1alpha、IL-1RA和TNFalpha的微小变异是否存在的信息不太可能成为个体分类的有用工具。
{"title":"Significance of genetic information in risk assessment and individual classification using silicosis as a case model.","authors":"E. McCanlies, D. Landsittel, B. Yucesoy, V. Vallyathan, Michael Luster, D. Sharp","doi":"10.1093/ANNHYG/MEF055","DOIUrl":"https://doi.org/10.1093/ANNHYG/MEF055","url":null,"abstract":"Over the last decade the role of genetic data in epidemiological research has expanded considerably. We recently published a case-control study that evaluated the interaction between silica exposure and minor variants in the genes coding for interleukin-1alpha (IL-1alpha), interleukin-1 receptor antagonist (IL-1RA) and tumor necrosis factor alpha (TNFalpha) as risk factors associated with silicosis, a fibrotic lung disease. In contrast, this report uses data generated from these studies to illustrate the utility of genetic information for the purposes of risk assessment and clinical prediction. Specifically, this study will address how, given a known exposure, genetic information affects the characterization of risk groups. Relative operating characteristic (ROC) curves were then used to determine the impact of genetic information on individual classification. Logistic regression modeling procedures were used to estimate the predicted probability of developing silicosis. This probability was then used to construct predicted risk deciles, first for a model with occupational exposure only and then for a model containing occupational exposure and genetic main effects and interactions. Results indicate that the exposure-only model effectively captures an increasing relationship between predicted risk deciles and prevalence of observed silicosis cases. Individuals comprising the highest risk decile were almost four times as likely to have silicosis as opposed to the lowest risk decile. The addition of genetic data, however, substantially improved characterization of risk categories; the proportion of cases in the highest risk decile was almost eight times that in the lowest risk decile. However, the ROC curve and classification analysis demonstrated that the addition of genetic main effects and interactions did not significantly impact on prediction of the individual's case status. These results indicate that genetic information plays a valuable role in effectively characterizing risk groups and mechanisms of disease operating in a substantial proportion of the population. However, in the case of fibrotic lung disease caused by silica exposure, information about the presence or absence of the minor variants of IL-1alpha, IL-1RA and TNFalpha is unlikely to be a useful tool for individual classification.","PeriodicalId":342592,"journal":{"name":"The Annals of occupational hygiene","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131950504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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